Traumatic intrusion of maxillary permanent incisors into the nasal cavity associated with a seizure disorder: report of a case

Abstract –  Childhood traumatic dental injury is typically associated with motor vehicle accidents, sports, or other recreational activities. However, seizure disorders or other compromising medical conditions may precipitate dental trauma. Complete intrusion injuries in the mixed or permanent dentition are relatively rare. This paper describes the case history of an adolescent male who sustained displacement of a lateral incisor into the nasal cavity and complete bony intrusion of the three other permanent maxillary incisors because of a fall following a seizure. Counseling on helmet/face-shield usage for seizure-susceptible patients must be provided and documented, particularly after sustaining traumatic injury.     

A proof-of-concept study to assess the putative dose response to topical corticosteroid in persistent allergic rhinitis using adenosine monophosphate challenge

INTRODUCTION: The aim of this proof-of-concept study was to assess whether nasal adenosine monophosphate (AMP) challenge may be used to quantify dose response to topical fluticasone propionate (FP) in persistent allergic rhinitis (PER). METHODS: Eligible subjects with PER entered a randomized double-blind crossover study of 2 weeks of intranasal FP at 100 microg or 400 microg daily, with a 2-week placebo washout period before each randomized treatment. Measurements after each washout or treatment comprised: peak nasal inspiratory flow (PNIF) response to nasal AMP (the primary outcome), domiciliary PNIF, the mini rhinoconjunctivitis quality of life questionnaire (miniRQLQ), symptom scores, nasal nitric oxide levels and overnight urinary cortisol:creatinine ratios. RESULTS: Thirteen patients completed per protocol. Maximal PNIF response to AMP was attenuated 0.9% (95% confidence interval -7.1 to 9.0, P=NS) by FP 100 microg, and 12.9% (4.8-20.9, P=0.009) by FP 400 microg. The 400-100 microg difference was 12.0% U (2.6-21.3, P=0.049). None of the other outcomes were responsive enough to detect any significant treatment effects. The standardized response means to FP 400 microg were 81% for AMP challenge, 54% for domiciliary PNIF, 53% for miniRQLQ, 24% for symptom scores and 18% for nasal nitric oxide. No adrenal suppression was detected at either dose. CONCLUSION: FP exhibited dose-related suppression of nasal airway hyperresponsiveness to AMP challenge, but without associated detectable adrenal suppression at the higher dose. Moreover, the AMP response demonstrated the highest signal to noise ratio compared with other outcome measures in PER.     

A method for canine nasal mucosa superfusion, in vivo; evidence that pseudomonas-induced neutrophil migration is inhibited by α2-adrenoceptor agonist

Methods and Results A method for isolating and superfusing a segment of the nasal cavity in the anaesthetized dog was developed. Introduction of Pseudomonas aeruginosa supernatant (PA), which is known to induce IL-8 release, resulted in a marked time-dependent exponential increase in neutrophil recruitment to the nasal chamber. When oxymetazoline (final concentration. 10^-5 M), was added to the superfusate, the PA induced-neutrophil migration was inhibited; the addition of benzalchoniul chloride to the superfusate had no effect on the PA induced-neutrophil migration. Conclusion We conclude that a α₂ adrenoceptor agonist profoundly inhibits neutrophil migration in response to bacterial products. Our novel method allows continuous introduction of stimuli and monitoring of responses in the nasal mucosa.     

钡粉喷雾法直肠双对比造影的初步研究

作者自１９９４年１月以来创用钡喷雾法做直肠双对比造影４０例，诊断直肠癌８例。该法不仅可显示用传统方法能显示的肿块，还可显示用传统方法难以显示的肿块周围的小病灶，对肿瘤侵犯范围的诊断也比传统方法准确，是直肠早期占位病变的重要诊断方法之一。     

鼻窦内窥镜手术治疗鼻息肉43例疗效分析

观察４３例（７３侧）经鼻窦内窥镜手术治疗的鼻息肉患者的临床疗效，并随访３～１８个月。其中施行功能性筛窦手术４例（５侧），全筛窦切除术２３例（３８侧），全蝶筛窦切除术１６例（３０侧）；辅以同侧上领窦根治术７例（９侧）。术后下列症状完全消失：头痛（３０例，占９３．８％）；鼻塞（３５例，占９４．６％）、脓涕（２２例，占７０．９７％）。嗅觉完全或部分恢复者１７例（７０．８３％）。无严重并发症。随访期内鼻息肉残留－复发率１８．６０％（８／４３）。文中就该手术的临床疗效、适应症、手术方式选择和术前ＣＴ检查等方面进行了讨论。     

Advanced injection techniques of poly-L-lactic acid: a case-based presentation

ABSTRACT:  This article presents a patient who illustrates the current treatment techniques that optimize the efficacy and tolerability of poly-L-lactic acid.     

反复表面局部麻醉在鼻内窥镜手术中的应用研究(附104例报告)

目的　探讨鼻内窥镜手术新的局部麻醉方式 ,以延长麻醉时间 ,提高麻醉效果。方法　在 0 .5 %地卡因反复表面麻醉下 ,对 10 4例各型、期慢性鼻窦炎、鼻息肉患者施行鼻内窥镜手术 ,观察麻醉效果 ;并对其中 3 0例无心血管系统病史、肝肾功能正常患者进行反复应用地卡因安全性的动态监测 ,且设立传统局麻对照组 ,对比研究反复表面局部麻醉的效果。结果　反复表面麻醉的总体成功率为 92 .3 % ,麻醉效果优于对照组 (P <0 .0 5 ) ;未见中枢神经系统和心血管系统的毒性反应指标出现有意义的改变 (P >0 .0 5 ) ,亦未发生因疼痛引起鼻心反射。结论　在一定时间间隔和安全用量范围内 ,使用低浓度地卡因反复表面麻醉是安全有效的 ,是慢性鼻窦炎、鼻息肉鼻内窥镜手术的较佳选择     

The Role of Budesonide in Adults and Children with Mild-to-Moderate Persistent Asthma

Asthma, a chronic and potentially life-threatening disease of the airways, affects patients of all ages. Inhaled corticosteroids (ICS) are the recommended first-line therapy for patients with persistent asthma. To review the clinical efficacy and tolerability data available on budesonide in the treatment of mild-to-moderate persistent asthma, a MEDLINE database search was performed for 1996-2003 using the following key words: budesonide, inhaled corticosteroid, efficacy, safety, systemic. When administered once or twice daily, budesonide effectively controls asthma in children, adolescents, and adults with mild-to-moderate asthma. Budesonide can be delivered effectively via a dry powder inhaler (Pulmicort Turbuhaler®) in patients aged ≥ 6 years or as an inhalation suspension (Pulmicort Respules®) in children as young as 12 months. With over 20 years' clinical exposure, budesonide has been demonstrated to be well tolerated in the treatment of chronic asthma in patients as young as 12 months. Specifically, at doses required to treat mild or moderate persistent asthma, budesonide does not affect hypothalamic-pituitary-adrenal axis function, bone mineral density, cataract formation, or final adult height. As Pulmicort Turbuhaler®, budesonide is the only ICS to achieve a Food and Drug Administration pregnancy category B rating. Early intervention with budesonide is recommended in asthma management: maximum benefit from therapy is reported in patients treated within 2 years of disease recognition. Budesonide is effective and well tolerated in the control of mild-to-moderate persistent asthma in patients aged 12 months and older. There is no evidence for variation in efficacy in population subgroups.